The Quantified Self: How Far Would You Go?

Text by Tanushree Rao

Photography by Björn Rust & Carolyn Ang

*As the doctor did not wish to be identified, his name has been changed.

As more and more of us regularly use fitness trackers to monitor our movement and sleep patterns it’s becoming ever easier to stay focused on our health. But would you go so far as to ingest or inject trackers or tattoo them on your body? If the answer's 'yes' then you're not alone. Welcome to the world of internables.

There's no doubt that fitness trackers have changed the way we view our health from a movement and sleep perspective. But, what if your fitness tracker could identify whether your iron levels ran low, your fever was in the danger zone, or your heart rate was dangerously high? The truth is, they can.

The latter is what happened when Dr Diars*, a Sydney-based oncologist, who’s also a heart patient, realised his Fitbit was sending him warning signals. ‘I felt a bit uneasy and thought that my heart was racing,’ he says ‘The only way I was able to get an objective view was by looking at my Fitbit. It was contemplating 90 and 95 and I thought “this is unusual”, because my resting heart rate was always in the 70s.’

It was through paranoia, he joked, that he kept checking his Fitbit throughout the night and into the morning. ‘From 100 it went to 105 to 110 to 115 and 120 and when it reached 125, I just knew that it can’t be right,’ he says. ‘Common sense told me that it must be something to do with the heart. I phoned my cardiologist and he advised me to get into an ambulance and go to the nearest hospital.’

Shortly after this, Diars experienced a heart attack. Fortunately, given the early warning signals, he was already at the hospital and has since recovered well.

With the rise of the quantified self, where data is collected and used to collect personal information, technology is increasingly helping us to make better decisions about our bodies. Not only that, it also helps health providers understand an individual’s unique physiology.

Currently, these devices are mainly wearables: a band worn on the wrist, a clip on the belt loop, or a brain-sensing headband. But wearables are rapidly progressing and we’re seeing a new generation of ‘internables’: trackers embedded under the skin, swallowable trackers for athletes to monitor body temperature, cameras-in-a-pill that photograph the digestive system, tablets that verify whether you’ve taken your medicine, and even ‘FitBits for your vagina’ to help rebuild pelvic function after childbirth.

Last month, Harvard and MIT researchers released a proof of concept for smart tattoos. Called ‘DermalAbyss’, the project features creative body art that can monitor your insides and display data. Tattoos, in this project, become an interface for data visualisation.

The researchers began with the question of what’s next for wearables, and identified the opportunity for what we traditionally see as aesthetic to become functional. 'We explored the possibility of exposing biodata within the skin in order to monitor the condition of your health,’ says Katia Vega, a lead researcher in the project.

The ink acts as a biosensor, highlighting changes in sodium, glucose or pH levels. The researchers imagined a future where, for example, diabetics could monitor their need for insulin through a tattoo that changes colour according to glucose levels.

That future is getting closer, as diabetics already have the means to use a tiny tracker underneath the skin of the belly to consistently self-monitor, including which daily activities affect glucose. Partnerships have already been announced between Dexcom, the company that manufactures these trackers, and both Fitbit and Apple so new-generation smartwatches can show data on demand.

So how long will it be before tattoo artists can provide smart ink art?

According to Vega, while they’ve had a positive response from the public, they won’t be looking to market a product any time soon.
‘The purpose of the work is to highlight a novel possibility for biosensors rather than bring a medical device to market,’ she says. ‘There are currently no plans to develop The DermalAbyss as a product or to pursue clinical trials.’

A number of ethical considerations also remain.

While quantified self devices can provide useful data, Dr Diars cautions against using them as diagnostic tools without a medical background. ‘It’s a double-edged sword,' he says. 'There’s so much advance in medicine and technology and we need to change with that. But there are dangers in totally trusting equipment when not knowing how it’s calibrated.’

He emphasises the need for controlled clinical trials, ethical approvals and clear, transparent messaging to avoid a situation where a user may assume simplicity and interpret data the wrong way. If we get this right then the technology could have real impact. When a health provider can gain a better insight into our personal situation then it not only makes our lives easier it also improves our chance of survival.

Privacy, however, remains a significant concern for bioethicists, technological ethicists and the wider public. While new developments are constantly challenging ideas about the self, perceptions of invasiveness still exist when talking about technology that sits inside us. Though exponential growth in technology can drive down costs over time, uptake depends largely on attitudes towards the human body and quality of life. It’s possible that soon, we’ll be able to seamlessly beam our data to the doctor’s office for better analysis and health advice.

“When a health provider can gain a better insight into our personal situation then it not only makes our lives easier it also improves our chance of survival.”

Tanushree Rao is a communicator and advisor in international development, currently based in Timor-Leste. She also writes on the subjects of technology, innovation, global development and social impact.

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